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NPI Code Detail

MEDICARE: COURTNEY R BURNETT M. ED, BCBA

MEDICARE:   COURTNEY R BURNETT  M. ED, BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-09-5661WA

General Provider Information

NPI Number : 1851665202
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY R BURNETT M. ED, BCBA
Provider Business Mailing Address
First Line : 8709 PALATINE AVE N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-3621
Country : US
Telephone Number : 206-962-0960
Fax Number :
Provider Business Practice Location Address
First Line : 5031 UNIVERSITY WAY NE
Second Line :
City : SEATTLE
State : WA
Zip : 98105-4341
Country : US
Telephone Number : 206-962-0960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2012
Last Update Date : 10/15/2015

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Directions to “ COURTNEY R BURNETT M. ED, BCBA” Practice Location

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